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The subject of ethics has not been explored extensively by the clinical laboratory community, but a scientific session at the 71st AACC Annual Scientific Meeting & Clinical Lab Expo in Anaheim, California, Ethical Issues in Laboratory Medicine (32101), plans to start a conversation on this topic. The speakers will present the core principles of biomedical ethics, then use case studies to frame these principles and weigh the risks and benefits of difficult situations.

Session speaker Ann Gronowski, PhD, DABCC, a professor of pathology and immunology and obstetrics and gynecology at Washington University School of Medicine in St. Louis, suspects that labs haven’t paid much attention to ethics due to a lack of contact with patients. Nonetheless, labs are still involved in patient care—and can face difficult ethical decisions. “Like other medical professionals, laboratorians have a fiduciary duty to act in the best interest of our patients,” Gronowski told CLN Stat.

Moderated by Carey-Ann Burnham, PhD, D(ABMM), FIDSA, F(AAM), professor of pathology and immunology, molecular microbiology, and pediatrics at Washington University School of Medicine, the session will explore ethical issues involving emerging infections and clinical laboratories. Gronowski will discuss the basics of biomedical ethics, review the history of biomedical ethics, and the core principles of modern biomedical ethics, including autonomy, beneficence (nonmaleficence), and justice. Sheldon Campbell, PhD, MD, professor of laboratory medicine at Yale University School of Medicine in New Haven, Connecticut, will examine the interface of ethics related to emerging infections and clinical laboratories.

The plan is to discuss incidental findings with clinically actionable results, Gronowski said. “This is when a laboratory gets important results to tests that were not actually ordered by a physician,” she elaborated. “Healthcare professionals need to weigh the risks and benefits of disclosing results that were not ordered and respect the rights of patients to not know certain results.”

The speakers will also discuss the rights that subjects have to withdraw from research studies and the rights that patients have to refuse laboratory testing, situations that potentially generate conflict between patient autonomy and the duty for healthcare professionals to act with beneficence, Gronowski explained. Campbell will discuss specifically the ethical difficulties that arise with emerging disease outbreaks such as Ebola. “In these cases, the rights of patients to quality healthcare have to be weighed against the risk to healthcare workers. Dr. Campbell will talk about risk assessment in these difficult cases,” said Gronowski.

Both speakers plan to use actual case studies to illustrate their points, asking the audience how they would handle various sessions. Ethics don’t always present clear cut right and wrong answers, Gronowski emphasized. “Options need to be discussed, and the best solution is determined based on the individual circumstances,” she said. “We will also discuss alternative solutions and resources that laboratorians can use as they deal with difficult ethical cases.”

Gronowski’s interest in ethics came about from her own experiences with error disclosure, incidental findings, and patients refusing certain types of testing. “I learned a lot when dealing with those cases and that led to a few publications on the ethical considerations involved in the decisionmaking process,” she said. Presenting a symposium was another way for her to share what she learned with a wider audience. “Dr. Burnham and I gave a similar session last year at the American Society of Microbiology, and it was very well-attended with great discussion. We thought that this type of content would also be of interest to AACC attendees.”

This 71st AACC Annual Scientific Meeting & Clinical Lab Expo session will take place August 5 from 10:30 a.m. to noon and is worth 1.5 ACCENT credit hours.